32
CAUTION
Please fill in this form before servicing.
Hand over this form to the service engineer to keep for his and your safety.
Safety check sheet
1. Freezer contents :
□
Yes
□
No
Risk of infection:
□
Yes
□
No
Risk of toxicity:
□
Yes
□
No
Risk from radioactive sources:
□
Yes
□
No
(List all potentially hazardous materials that have been stored in this unit.)
Notes :
2.
Contamination
of the unit:
Unit interior:
□
Yes
□
No
No contamination:
□
Yes
□
No
Decontaminated:
□
Yes
□
No
Contaminated:
□
Yes
□
No
Others:
3. Instructions for safe repair/maintenance of the unit
a) The unit is safe to work on
□
Yes
□
No
b) There is some danger (see below)
□
Yes
□
No
Procedure to be adhered to in order to reduce safety risk indicated in b) below.
Date :
Signature :
Address, Division :
Telephone :
Product
name:
Model:
Serial
number:
Date of installation:
Biomedical Freezer
MDF-
Please decontaminate the unit yourself before calling the service engineer.
